Civic Intelligence
Filing

Path Employee Health Plan

Program for Appropriate Technology • EIN 91-1157127 • Plan year 2000

Company ProfileSource Archive

View Related Profile

Filing Insights

Participants

Up

164 → 191

27 • 16.46%

Assets

No comparison

- → -

No earlier value available.

Investment Management Fee

-

Admin expenses - • Total expenses -

Filing Details

Context

No event flags were generated for this filing.

Status Flags

Fidelity bond in place

Not reported

Limited-scope audit performed

Not reported

Contributions transmitted on time

Not reported

Participant loans in default

Not reported

Leases in default

Not reported

Reportable party-in-interest issues

Not reported

Loss discovered during year

Not reported

Assets with undetermined value

Not reported

Non-cash contributions

Not reported

Assets held for investment

Not reported

5% transactions reported

Not reported

All plan assets distributed

Not reported

Benefits paid when due

Not reported

Plan blackout period

Not reported

Plan termination resolution adopted

Not reported

Counterparties

Company Timeline

This filing is highlighted inside the broader sponsor history.

Year / FilingFilingsParticipantsAssetsContributionsContrib./Participant
20242581$300,771,394$18,327,147$31,544iApproximate average salary by contribution assumption: employee only about $788,604 at 4% or $525,736 at 6%; with 50% employer match about $525,736 at 4% or $350,490 at 6%; with 100% employer match about $394,302 at 4% or $262,868 at 6%.
Path Profit Sharing 401(K) Incentive Plan-532$300,771,394$18,327,147$34,450iApproximate average salary by contribution assumption: employee only about $861,238 at 4% or $574,159 at 6%; with 50% employer match about $574,159 at 4% or $382,772 at 6%; with 100% employer match about $430,619 at 4% or $287,079 at 6%.
Path Employee Health Plan-581---
20232581$272,970,138$17,172,590$29,557iApproximate average salary by contribution assumption: employee only about $738,924 at 4% or $492,616 at 6%; with 50% employer match about $492,616 at 4% or $328,411 at 6%; with 100% employer match about $369,462 at 4% or $246,308 at 6%.
Path Profit Sharing 401(K) Incentive Plan-580$272,970,138$17,172,590$29,608iApproximate average salary by contribution assumption: employee only about $740,198 at 4% or $493,465 at 6%; with 50% employer match about $493,465 at 4% or $328,977 at 6%; with 100% employer match about $370,099 at 4% or $246,733 at 6%.
Path Employee Health Plan-581---
20222575$227,718,490$17,048,971$29,650iApproximate average salary by contribution assumption: employee only about $741,260 at 4% or $494,173 at 6%; with 50% employer match about $494,173 at 4% or $329,449 at 6%; with 100% employer match about $370,630 at 4% or $247,087 at 6%.
Path Profit Sharing 401(K) Incentive Plan-575$227,718,490$17,048,971$29,650iApproximate average salary by contribution assumption: employee only about $741,260 at 4% or $494,173 at 6%; with 50% employer match about $494,173 at 4% or $329,449 at 6%; with 100% employer match about $370,630 at 4% or $247,087 at 6%.
Path Employee Health Plan-530---
20212576$279,663,878$16,435,535$28,534iApproximate average salary by contribution assumption: employee only about $713,348 at 4% or $475,565 at 6%; with 50% employer match about $475,565 at 4% or $317,043 at 6%; with 100% employer match about $356,674 at 4% or $237,783 at 6%.
Path Profit Sharing 401(K) Incentive Plan-576$279,663,878$16,435,535$28,534iApproximate average salary by contribution assumption: employee only about $713,348 at 4% or $475,565 at 6%; with 50% employer match about $475,565 at 4% or $317,043 at 6%; with 100% employer match about $356,674 at 4% or $237,783 at 6%.
Path Employee Health Plan-563---
20202593$242,207,044$16,465,565$27,767iApproximate average salary by contribution assumption: employee only about $694,164 at 4% or $462,776 at 6%; with 50% employer match about $462,776 at 4% or $308,517 at 6%; with 100% employer match about $347,082 at 4% or $231,388 at 6%.
Path Profit Sharing 401(K) Incentive Plan-593$242,207,044$16,465,565$27,767iApproximate average salary by contribution assumption: employee only about $694,164 at 4% or $462,776 at 6%; with 50% employer match about $462,776 at 4% or $308,517 at 6%; with 100% employer match about $347,082 at 4% or $231,388 at 6%.
Path Employee Health Plan-542---
20192605$205,852,134$15,520,422$25,654iApproximate average salary by contribution assumption: employee only about $641,340 at 4% or $427,560 at 6%; with 50% employer match about $427,560 at 4% or $285,040 at 6%; with 100% employer match about $320,670 at 4% or $213,780 at 6%.
Path Profit Sharing 401(K) Incentive Plan-605$205,852,134$15,520,422$25,654iApproximate average salary by contribution assumption: employee only about $641,340 at 4% or $427,560 at 6%; with 50% employer match about $427,560 at 4% or $285,040 at 6%; with 100% employer match about $320,670 at 4% or $213,780 at 6%.
Path Employee Health Plan-542---
20182643$173,611,913$16,584,592$25,793iApproximate average salary by contribution assumption: employee only about $644,813 at 4% or $429,875 at 6%; with 50% employer match about $429,875 at 4% or $286,584 at 6%; with 100% employer match about $322,407 at 4% or $214,938 at 6%.
Path Profit Sharing 401(K) Incentive Plan-643$173,611,913$16,584,592$25,793iApproximate average salary by contribution assumption: employee only about $644,813 at 4% or $429,875 at 6%; with 50% employer match about $429,875 at 4% or $286,584 at 6%; with 100% employer match about $322,407 at 4% or $214,938 at 6%.
Path Employee Health Plan-612---
20172691$179,283,245$15,656,646$22,658iApproximate average salary by contribution assumption: employee only about $566,449 at 4% or $377,633 at 6%; with 50% employer match about $377,633 at 4% or $251,755 at 6%; with 100% employer match about $283,224 at 4% or $188,816 at 6%.
Path Profit Sharing 401(K) Incentive Plan-689$179,283,245$15,656,646$22,724iApproximate average salary by contribution assumption: employee only about $568,093 at 4% or $378,729 at 6%; with 50% employer match about $378,729 at 4% or $252,486 at 6%; with 100% employer match about $284,047 at 4% or $189,364 at 6%.
Path Employee Health Plan-691---
20163658$142,282,561$13,149,785$19,984iApproximate average salary by contribution assumption: employee only about $499,612 at 4% or $333,075 at 6%; with 50% employer match about $333,075 at 4% or $222,050 at 6%; with 100% employer match about $249,806 at 4% or $166,537 at 6%.
Path Profit Sharing 401(K) Incentive Plan-658$142,282,561$13,149,785$19,984iApproximate average salary by contribution assumption: employee only about $499,612 at 4% or $333,075 at 6%; with 50% employer match about $333,075 at 4% or $222,050 at 6%; with 100% employer match about $249,806 at 4% or $166,537 at 6%.
Path Employee Health Plan-619---
Path Life and Disability Plan-0---
20153648$127,756,886$13,609,868$21,003iApproximate average salary by contribution assumption: employee only about $525,072 at 4% or $350,048 at 6%; with 50% employer match about $350,048 at 4% or $233,365 at 6%; with 100% employer match about $262,536 at 4% or $175,024 at 6%.
Path Profit Sharing 401(K) Incentive Plan-635$127,756,886$13,609,868$21,433iApproximate average salary by contribution assumption: employee only about $535,822 at 4% or $357,214 at 6%; with 50% employer match about $357,214 at 4% or $238,143 at 6%; with 100% employer match about $267,911 at 4% or $178,607 at 6%.
Path Employee Health Plan-615---
Path Life and Disability Plan-648---
20143619$123,064,540$12,749,289$20,597iApproximate average salary by contribution assumption: employee only about $514,915 at 4% or $343,276 at 6%; with 50% employer match about $343,276 at 4% or $228,851 at 6%; with 100% employer match about $257,457 at 4% or $171,638 at 6%.
Path Profit Sharing 401(K) Incentive Plan-618$123,064,540$12,749,289$20,630iApproximate average salary by contribution assumption: employee only about $515,748 at 4% or $343,832 at 6%; with 50% employer match about $343,832 at 4% or $229,221 at 6%; with 100% employer match about $257,874 at 4% or $171,916 at 6%.
Path Life and Disability Plan-619---
Path Employee Health Plan-604---
20133617$109,614,295$11,088,491$17,972iApproximate average salary by contribution assumption: employee only about $449,291 at 4% or $299,527 at 6%; with 50% employer match about $299,527 at 4% or $199,685 at 6%; with 100% employer match about $224,645 at 4% or $149,764 at 6%.
Path Profit Sharing 401(K) Incentive Plan-605$109,614,295$11,088,491$18,328iApproximate average salary by contribution assumption: employee only about $458,202 at 4% or $305,468 at 6%; with 50% employer match about $305,468 at 4% or $203,645 at 6%; with 100% employer match about $229,101 at 4% or $152,734 at 6%.
Path Employee Health Plan-590---
Path Life and Disability Plan-617---
20123551$85,295,755$10,019,653$18,184iApproximate average salary by contribution assumption: employee only about $454,612 at 4% or $303,075 at 6%; with 50% employer match about $303,075 at 4% or $202,050 at 6%; with 100% employer match about $227,306 at 4% or $151,537 at 6%.
Path Profit Sharing 401(K) Incentive Plan-551$85,295,755$10,019,653$18,184iApproximate average salary by contribution assumption: employee only about $454,612 at 4% or $303,075 at 6%; with 50% employer match about $303,075 at 4% or $202,050 at 6%; with 100% employer match about $227,306 at 4% or $151,537 at 6%.
Path Life and Disability Plan-550---
Path Employee Health Plan-534---
20113529$70,976,646$8,162,211$15,430iApproximate average salary by contribution assumption: employee only about $385,738 at 4% or $257,159 at 6%; with 50% employer match about $257,159 at 4% or $171,439 at 6%; with 100% employer match about $192,869 at 4% or $128,579 at 6%.
Path Profit Sharing 401(K) Incentive Plan-515$70,976,646$8,162,211$15,849iApproximate average salary by contribution assumption: employee only about $396,224 at 4% or $264,149 at 6%; with 50% employer match about $264,149 at 4% or $176,099 at 6%; with 100% employer match about $198,112 at 4% or $132,075 at 6%.
Path Employee Health Plan-509---
Path Life and Disability Plan-529---
20103482$64,887,038$8,079,605$16,763iApproximate average salary by contribution assumption: employee only about $419,067 at 4% or $279,378 at 6%; with 50% employer match about $279,378 at 4% or $186,252 at 6%; with 100% employer match about $209,533 at 4% or $139,689 at 6%.
Path Profit Sharing 401(K) Incentive Plan-482$64,887,038$8,079,605$16,763iApproximate average salary by contribution assumption: employee only about $419,067 at 4% or $279,378 at 6%; with 50% employer match about $279,378 at 4% or $186,252 at 6%; with 100% employer match about $209,533 at 4% or $139,689 at 6%.
Path Life and Disability Plan-----
Path Employee Health Plan-449---
20093487$51,567,717$7,504,524$15,410iApproximate average salary by contribution assumption: employee only about $385,243 at 4% or $256,828 at 6%; with 50% employer match about $256,828 at 4% or $171,219 at 6%; with 100% employer match about $192,621 at 4% or $128,414 at 6%.
Path Profit Sharing 401(K) Incentive Plan-467$51,567,717$7,504,524$16,070iApproximate average salary by contribution assumption: employee only about $401,741 at 4% or $267,827 at 6%; with 50% employer match about $267,827 at 4% or $178,552 at 6%; with 100% employer match about $200,871 at 4% or $133,914 at 6%.
Path Employee Health Plan-441---
Path Life and Disability Plan-487---
20083408$34,193,414$6,284,787$15,404iApproximate average salary by contribution assumption: employee only about $385,097 at 4% or $256,731 at 6%; with 50% employer match about $256,731 at 4% or $171,154 at 6%; with 100% employer match about $192,549 at 4% or $128,366 at 6%.
Path Profit Sharing 401(K) Incentive Plan-408$34,193,414$6,284,787$15,404iApproximate average salary by contribution assumption: employee only about $385,097 at 4% or $256,731 at 6%; with 50% employer match about $256,731 at 4% or $171,154 at 6%; with 100% employer match about $192,549 at 4% or $128,366 at 6%.
Path Employee Health Plan-395---
Path Life and Disability Plan-375---
20074362$44,730,833$5,261,980$14,536iApproximate average salary by contribution assumption: employee only about $363,396 at 4% or $242,264 at 6%; with 50% employer match about $242,264 at 4% or $161,510 at 6%; with 100% employer match about $181,698 at 4% or $121,132 at 6%.
Path Profit Sharing 401(K) Incentive Plan-350$44,730,833$5,261,980$15,034iApproximate average salary by contribution assumption: employee only about $375,856 at 4% or $250,570 at 6%; with 50% employer match about $250,570 at 4% or $167,047 at 6%; with 100% employer match about $187,928 at 4% or $125,285 at 6%.
PATH FLEXIBLE BENEFITS PLAN-143---
Path Employee Health Plan-337---
Path Life and Disability Plan-362---
20064314$39,941,462$4,246,659$13,524iApproximate average salary by contribution assumption: employee only about $338,110 at 4% or $225,407 at 6%; with 50% employer match about $225,407 at 4% or $150,271 at 6%; with 100% employer match about $169,055 at 4% or $112,703 at 6%.
Path Profit Sharing 401(K) Incentive Plan-307$39,941,462$4,246,659$13,833iApproximate average salary by contribution assumption: employee only about $345,819 at 4% or $230,546 at 6%; with 50% employer match about $230,546 at 4% or $153,697 at 6%; with 100% employer match about $172,910 at 4% or $115,273 at 6%.
Path Employee Health Plan-279---
Path Life and Disability Plan-314---
PATH FLEXIBLE BENEFITS PLAN-145---
20054272$34,810,918$3,760,377$13,825iApproximate average salary by contribution assumption: employee only about $345,623 at 4% or $230,415 at 6%; with 50% employer match about $230,415 at 4% or $153,610 at 6%; with 100% employer match about $172,811 at 4% or $115,208 at 6%.
Path Profit Sharing 401(K) Incentive Plan-270$34,810,918$3,760,377$13,927iApproximate average salary by contribution assumption: employee only about $348,183 at 4% or $232,122 at 6%; with 50% employer match about $232,122 at 4% or $154,748 at 6%; with 100% employer match about $174,092 at 4% or $116,061 at 6%.
AMENDED PATH PENSION PLAN AND TRUST-0---
Path Employee Health Plan-234---
Path Life and Disability Plan-272---
20044264$32,209,082$3,703,912$14,030iApproximate average salary by contribution assumption: employee only about $350,749 at 4% or $233,833 at 6%; with 50% employer match about $233,833 at 4% or $155,889 at 6%; with 100% employer match about $175,375 at 4% or $116,916 at 6%.
AMENDED PATH PENSION PLAN AND TRUST-235$16,344,431$1,585,203$6,746iApproximate average salary by contribution assumption: employee only about $168,639 at 4% or $112,426 at 6%; with 50% employer match about $112,426 at 4% or $74,950 at 6%; with 100% employer match about $84,319 at 4% or $56,213 at 6%.
Path Profit Sharing 401(K) Incentive Plan-264$15,864,651$2,118,709$8,025iApproximate average salary by contribution assumption: employee only about $200,635 at 4% or $133,757 at 6%; with 50% employer match about $133,757 at 4% or $89,171 at 6%; with 100% employer match about $100,318 at 4% or $66,878 at 6%.
Path Employee Health Plan-229---
Path Life and Disability Plan-264---
20035285$27,614,182$3,637,923$12,765iApproximate average salary by contribution assumption: employee only about $319,116 at 4% or $212,744 at 6%; with 50% employer match about $212,744 at 4% or $141,829 at 6%; with 100% employer match about $159,558 at 4% or $106,372 at 6%.
AMENDED PATH PENSION PLAN AND TRUST-262$14,401,810$1,846,194$7,047iApproximate average salary by contribution assumption: employee only about $176,164 at 4% or $117,442 at 6%; with 50% employer match about $117,442 at 4% or $78,295 at 6%; with 100% employer match about $88,082 at 4% or $58,721 at 6%.
Path Profit Sharing 401(K) Incentive Plan-285$13,212,372$1,791,729$6,287iApproximate average salary by contribution assumption: employee only about $157,169 at 4% or $104,779 at 6%; with 50% employer match about $104,779 at 4% or $69,853 at 6%; with 100% employer match about $78,585 at 4% or $52,390 at 6%.
PATH FLEXIBLE BENEFITS PLAN-107---
Path Life and Disability Plan-276---
Path Employee Health Plan-236---
20024262$22,085,090$3,311,032$12,638iApproximate average salary by contribution assumption: employee only about $315,938 at 4% or $210,625 at 6%; with 50% employer match about $210,625 at 4% or $140,417 at 6%; with 100% employer match about $157,969 at 4% or $105,313 at 6%.
AMENDED PATH PENSION PLAN AND TRUST-262$11,596,190$1,665,373$6,356iApproximate average salary by contribution assumption: employee only about $158,910 at 4% or $105,940 at 6%; with 50% employer match about $105,940 at 4% or $70,627 at 6%; with 100% employer match about $79,455 at 4% or $52,970 at 6%.
Path Profit Sharing 401(K) Incentive Plan-205$10,488,900$1,645,659$8,028iApproximate average salary by contribution assumption: employee only about $200,690 at 4% or $133,793 at 6%; with 50% employer match about $133,793 at 4% or $89,196 at 6%; with 100% employer match about $100,345 at 4% or $66,897 at 6%.
Path Life and Disability Plan-258---
Path Employee Health Plan-220---
20012241$0$0-
Path Employee Health Plan-203---
Path Life and Disability Plan-241---
20002205$0$0-
Path Employee Health PlanCurrent191---
Path Life and Disability Plan-205---
19992170$0$0-
Path Life and Disability Plan-170---
Path Employee Health Plan-158---
Schedule Details

Schedule A

Row 1
Filing Id
84037105321812
Form Id
14493216
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
40372105321060002
Ins Broker 01 Name
THE REPPOND COMPANY, INC.
Ins Broker 01 Street Addr
10900 NE 4TH STREET, SUITE 1200
Ins Broker 01 City
BELLEVUE
Ins Broker 01 State
WA
Ins Broker 01 ZIP Code
98004
Ins Broker Comm Pd 01 Amount
$26,985
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 2
Filing Id
84037105321812
Form Id
14493217
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
40372105321060003
Ins Broker 01 Name
THE REPPOND COMPANY, INC.
Ins Broker 01 Street Addr
10900 NE 4TH STREET, SUITE 1200
Ins Broker 01 City
BELLEVUE
Ins Broker 01 State
WA
Ins Broker 01 ZIP Code
98004
Ins Broker Comm Pd 01 Amount
$4,787
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 3
Filing Id
84037105321812
Form Id
14493218
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
40372105321060004
Ins Broker Comm Pd 01 Amount
$0
Ins Broker Fees Pd 01 Amount
$0
Row 4
Filing Id
84037105321812
Form Id
14493219
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
40372105321060005
Ins Broker 01 Name
THE REPPOND COMPANY, INC.
Ins Broker 01 Street Addr
10900 NE FOURTH STREET, SUITE 1200
Ins Broker 01 City
BELLEVUE
Ins Broker 01 State
WA
Ins Broker 01 ZIP Code
98004
Ins Broker Comm Pd 01 Amount
$5,101
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 5
Ins Carrier Name: GROUP HEALTH COOPERATIVE OF PUGET SOUND
Filing Id
84037105321812
Form Id
14493217
Schedule A EIN
91-1157127
Schedule A Plan Num
511
Schedule A Plan Year Begin Date
2000-02-01
Schedule A Tax Period
20010131
Ins Carrier Name
GROUP HEALTH COOPERATIVE OF PUGET SOUND
Ins Carrier EIN
91-0511770
Ins Carrier Naic Code
95672
Ins Contract Num
2569
Ins Prsn Covered End of year Count
30
Ins Policy From Date
2000-02-01
Ins Policy To Date
2001-01-31
Ins Broker Comm Total Amount
$4,787
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
A
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$99,478
Wlfr Acquis Cost Amount
$0
Row 6
Ins Carrier Name: AETNA U.S. HEALTHCARE, INC.
Filing Id
84037105321812
Form Id
14493218
Schedule A EIN
91-1157127
Schedule A Plan Num
511
Schedule A Plan Year Begin Date
2000-02-01
Schedule A Tax Period
20010131
Ins Carrier Name
AETNA U.S. HEALTHCARE, INC.
Ins Carrier EIN
22-2229683
Ins Carrier Naic Code
95590
Ins Contract Num
669297
Ins Prsn Covered End of year Count
11
Ins Policy From Date
2000-02-01
Ins Policy To Date
2001-01-31
Ins Broker Comm Total Amount
$0
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
A
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$36,603
Wlfr Acquis Cost Amount
$2,915
Wlfr Acquis Cost Text
PREMIUM DUE BUT UNPAID AT THE END OF THE YEAR
Row 7
Ins Carrier Name: AETNA GLOBAL BENEFITS
Filing Id
84037105321812
Form Id
14493219
Schedule A EIN
91-1157127
Schedule A Plan Num
511
Schedule A Plan Year Begin Date
2000-02-01
Schedule A Tax Period
20010131
Ins Carrier Name
AETNA GLOBAL BENEFITS
Ins Carrier EIN
98-0211470
Ins Carrier Naic Code
0
Ins Contract Num
299082-52-119
Ins Prsn Covered End of year Count
14
Ins Policy From Date
2000-02-01
Ins Policy To Date
2001-01-31
Ins Broker Comm Total Amount
$5,101
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
AB
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$51,014
Wlfr Acquis Cost Amount
$0
Row 8
Ins Carrier Name: REGENCE BLUE SHIELD
Filing Id
84037105321812
Form Id
14493216
Schedule A EIN
91-1157127
Schedule A Plan Num
511
Schedule A Plan Year Begin Date
2000-02-01
Schedule A Tax Period
20010131
Ins Carrier Name
REGENCE BLUE SHIELD
Ins Carrier EIN
91-0282080
Ins Carrier Naic Code
53902
Ins Contract Num
035783
Ins Prsn Covered End of year Count
180
Ins Policy From Date
2000-02-01
Ins Policy To Date
2001-01-31
Ins Broker Comm Total Amount
$26,985
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
AB
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$500,218
Wlfr Acquis Cost Amount
$0